Signs and Symptoms
Uterine fibroids oftentimes do not cause noticeable signs or symptoms (Mitwally 2013). However, fibroids can cause pain, pressure, and a significant reduction in quality of life (Bulun 2013; Zimmermann 2012). Symptoms are generally dependent on the number, location, and size of fibroids (Mayo Clinic 2014a). On rare occasions, extremely large fibroids have been known to cause the uterus to expand to a size similar to that of the sixth or seventh month of pregnancy (Bulun 2013).
The most frequently reported symptom of uterine fibroids is increased and prolonged menstruation, that is, heavy bleeding and bleeding outside of the normal menstrual cycle (Gonsalves 2008; Mayo Clinic 2014a; Ferri 2014; Zimmermann 2012). Other possible fibroid symptoms include pelvic pain or pressure, leg or back pain, painful intercourse, increased urinary frequency or incontinence, and constipation. Infertility or pregnancy complications, including miscarriage, are also possible (Zimmermann 2012; Gonsalves 2008; Mitwally 2013).
Symptoms can also vary according to the location of the fibroid. Submucosal fibroids grow toward and into the inner uterine cavity from the uterine wall and often cause heavy menstrual bleeding or fertility problems. Subserosal fibroids grow toward the outside of the uterus and may cause urinary problems, rectal pressure, or backache as a result of pressure on related structures. Intramural fibroids grow within the muscular wall of the uterus, potentially leading to heavy, prolonged periods; pain; and pressure (Mayo Clinic 2014a).
Less common complications of uterine fibroids include fluid accumulation in the abdominal cavity (ascites), slow blood flow in the veins of the legs, or rarely, transformation to a cancerous uterine sarcoma (Ferri 2014; Khan 2014; ACS 2014a).